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	<p style=" font-family: 宋体; font-size: 12pt; text-align: Center;">
</p></div>

<div id="_body" style="outline:none;min-height: calc(297mm - NaNcm - NaNcm - 0.65cm - 0.65cm);padding-left:1.35cm;padding-right:1.35cm;" contenteditable="false">
	<p style=" font-family: 宋体; font-size: 12pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 12pt; color: #201F35; font-weight: bold;">                                          </label>
		<label style=" font-family: 宋体; font-size: 10.5pt; color: #201F35;">（组织机构代码：</label>
		<a tabindex="0" id="orgCode" name="组织机构代码" class="blank input" style=" font-family: 宋体; font-size: 10.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder=""></a>
		<label style=" font-family: 宋体; font-size: 10.5pt; text-align: Center;">)</label>
	</p><p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 12pt; color: #201F35; font-weight: bold;">                                                             </label>
		<label style=" font-family: 宋体; font-size: 10.5pt; color: #201F35;">住院号：</label>
		<a tabindex="0" id="field342" class="blank input" style=" font-family: 宋体; font-size: 10.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder=""></a>
	</p><p style=" font-family: 宋体; font-size: 12pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 14.25pt; color: #201F35; font-weight: bold;"> 住 院 病 案 首 页 </label>
	</p><p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">医疗付费方式：</label>
		<a tabindex="0" id="field263" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;},{&quot;Text&quot;:&quot;5&quot;,&quot;Value&quot;:&quot;5&quot;},{&quot;Text&quot;:&quot;6&quot;,&quot;Value&quot;:&quot;6&quot;},{&quot;Text&quot;:&quot;7&quot;,&quot;Value&quot;:&quot;7&quot;},{&quot;Text&quot;:&quot;8&quot;,&quot;Value&quot;:&quot;8&quot;},{&quot;Text&quot;:&quot;9&quot;,&quot;Value&quot;:&quot;9&quot;}]" value="" placeholder="1">1</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">健康卡号：</label>
		<a tabindex="0" id="field31" name="heCard" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;城镇职工基本医疗保险\t&quot;,&quot;Value&quot;:&quot;01&quot;},{&quot;Text&quot;:&quot;城镇居民基本医疗保险&quot;,&quot;Value&quot;:&quot;02&quot;},{&quot;Text&quot;:&quot;新型农村合作医疗&quot;,&quot;Value&quot;:&quot;03&quot;},{&quot;Text&quot;:&quot;贫困救助&quot;,&quot;Value&quot;:&quot;04&quot;},{&quot;Text&quot;:&quot;商业医疗保险&quot;,&quot;Value&quot;:&quot;05&quot;},{&quot;Text&quot;:&quot;全公费&quot;,&quot;Value&quot;:&quot;06&quot;},{&quot;Text&quot;:&quot;全自费&quot;,&quot;Value&quot;:&quot;07&quot;},{&quot;Text&quot;:&quot;其他社会保险&quot;,&quot;Value&quot;:&quot;08&quot;},{&quot;Text&quot;:&quot;其他&quot;,&quot;Value&quot;:&quot;09&quot;}]" value="" placeholder="城镇职工基本医疗保险	">城镇职工基本医疗保险	</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">            第</label>
		<a tabindex="0" id="field32" name="inHospTimes" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">次住院                  病案号：</label>
		<a tabindex="0" id="field33" name="baNO" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<table style="">
		<colgroup>
		<col style="width:714px">
		</colgroup>
		<tbody><tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">姓名</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="patientName" name="patientName" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">性别</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field272" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;0&quot;,&quot;Value&quot;:&quot;0&quot;},{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;9&quot;,&quot;Value&quot;:&quot;9&quot;}]" value="" placeholder="0">0</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.男 2.女 9.未说明的性别   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">出生日期</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field364" name="receiveInst" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">年龄</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="db4cf155-dfe8-4cb6-ad26-d95a94" name="age" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">国籍</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="3157c510-d0e7-4356-b313-34ce87" name="countryname" class="input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" type="DropdownList" value="01" placeholder="[object Object]">城镇职工基本医疗保险	</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (年龄不足1周岁的）</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">年龄</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field35" name="birthMonth" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 月                         </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">新生儿出生体重</label>
		<a tabindex="0" id="field36" name="birthKg" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 克       </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">新生儿入院体重</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field37" name="inKg" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 克</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">出生地</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="BirthAddrs" name="出生地" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">      </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">籍贯 </label>
		<a tabindex="0" id="NativePlace" name="籍贯" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">      </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">民族</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<a tabindex="0" id="National" name="民族" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Justify;" type="DropdownList" data="[{&quot;Text&quot;:&quot;汉族&quot;,&quot;Value&quot;:&quot;0001&quot;},{&quot;Text&quot;:&quot;满族&quot;,&quot;Value&quot;:&quot;0002&quot;},{&quot;Text&quot;:&quot;回族&quot;,&quot;Value&quot;:&quot;0003&quot;},{&quot;Text&quot;:&quot;蒙族&quot;,&quot;Value&quot;:&quot;0004&quot;},{&quot;Text&quot;:&quot;藏族&quot;,&quot;Value&quot;:&quot;0005&quot;},{&quot;Text&quot;:&quot;维吾尔族&quot;,&quot;Value&quot;:&quot;0006&quot;},{&quot;Text&quot;:&quot;苗族&quot;,&quot;Value&quot;:&quot;0007&quot;},{&quot;Text&quot;:&quot;彝（yí）族&quot;,&quot;Value&quot;:&quot;0008&quot;},{&quot;Text&quot;:&quot;壮族&quot;,&quot;Value&quot;:&quot;0009&quot;},{&quot;Text&quot;:&quot;布依族&quot;,&quot;Value&quot;:&quot;0010&quot;},{&quot;Text&quot;:&quot;朝鲜族&quot;,&quot;Value&quot;:&quot;0011&quot;},{&quot;Text&quot;:&quot;满族&quot;,&quot;Value&quot;:&quot;0012&quot;},{&quot;Text&quot;:&quot;侗（dòng）族&quot;,&quot;Value&quot;:&quot;0013&quot;},{&quot;Text&quot;:&quot;瑶族&quot;,&quot;Value&quot;:&quot;0014&quot;},{&quot;Text&quot;:&quot;白族&quot;,&quot;Value&quot;:&quot;0015&quot;},{&quot;Text&quot;:&quot;其他&quot;,&quot;Value&quot;:&quot;1012&quot;}]" value="" placeholder="汉族">汉族</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">身份证号</label>
		<a tabindex="0" id="field349" name="idcard" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="身份证号码his">
		</a><a tabindex="0" id="field349636717495450410625" name="cardno" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;"> 职业</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="33259708-e0a8-44bc-9e4e-845216" name="professionname" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">    </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">婚姻</label>
		<a tabindex="0" id="field279" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;},{&quot;Text&quot;:&quot;9&quot;,&quot;Value&quot;:&quot;9&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  1.未婚  2.已婚  3.丧偶  4.离婚 9.其他</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">现住址  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="NowAddress" name="现住址" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">电话</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="2073c2ec-89a8-4efb-8a7f-73a153" name="phone" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">邮编</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="3eda4612-2b6f-4306-84f6-ef3af5" name="homezip" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">户口地址</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="HomeAddress" name="户口地址" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">邮编</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="8b297666-9f8b-41af-95b5-929323" name="homepost" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">工作单位及地址</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="WorkAddress" name="工作地址" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">单位电话</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="WorkPhoneNum" name="单位联系电话" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">邮编</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="WorkPlacePost" name="工作地址邮编" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">联系人姓名</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="7497c7fb-c251-4b7b-a5bc-e6bb32" name="contract" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">关系</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="06898815-5852-46ab-9de4-59fa86" name="relation" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">地址</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="LinkmanAddr" name="联系人地址" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">电话</label>
		<a tabindex="0" id="field304" name="phone" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">入院途径</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field280" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  1.急诊 2.门诊 3.其他医疗机构转入 4.其他</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">入院时间</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="InHospDate" name="入院时间" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">入院科别</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="InHospDept" name="入院科别" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">病房</label>
		<a tabindex="0" id="InHospRoomTXT" name="病房描述" class=" input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="走廊 39" placeholder="">
		</a><a tabindex="0" id="InHospRoomNo" name="病房号" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder=""></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="InHospBedNo" name="病人床号" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder=""></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">转科科别</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="ChgDeptName" name="转科科室名称" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">出院时间 </label>
		<a tabindex="0" id="OutHospDate" name="出院时间" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">出院科别</label>
		<a tabindex="0" id="OutHospDept" name="出院科别" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">病房</label>
		<a tabindex="0" id="OutHospRoomTXT" name="出院病房描述" class=" input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="走廊 39" placeholder="">
		</a><a tabindex="0" id="OutHospRoomNo" name="出院病房号" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder=""></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="OutHospBedNo" name="出院病人床号" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder=""></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">实际住院</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="InHospDays" name="住院天数" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">天</label>
	</p><p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">门（急）诊诊断</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="OutPatiDiagName" name="门（急）诊诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">疾病编码</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="OutPatiDiagCode" name="疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 12pt;"> </label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<table style="">
		<colgroup>
		<col style="width:234px">
		<col style="width:66px">
		<col style="width:71px">
		<col style="width:204px">
		<col style="width:66px">
		<col style="width:67px">
		</colgroup>
		<tbody><tr style="height:0.3559322033898305cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">出院诊断</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;"> 疾病编码</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">入院病情</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">出院诊断</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">疾病编码</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">入院病情</label></p></td>
		</tr>
		<tr style="height:0.7959039330508475cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">主要诊断：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="MainOutHospDiagName" name="出院主要诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label><span style="font-size: 12pt; text-align: justify;">诱因</span><a tabindex="0" id="field302" name="field302" type="DropdownList" class="input" placeholder="诱因" value="1" data="[{&quot;Text&quot;:&quot;无明显诱因&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;手术后&quot;,&quot;Value&quot;:&quot;10&quot;},{&quot;Text&quot;:&quot;外伤后&quot;,&quot;Value&quot;:&quot;11&quot;},{&quot;Text&quot;:&quot;工作过度紧张&quot;,&quot;Value&quot;:&quot;12&quot;},{&quot;Text&quot;:&quot;长期卧床&quot;,&quot;Value&quot;:&quot;13&quot;},{&quot;Text&quot;:&quot;禁食&quot;,&quot;Value&quot;:&quot;14&quot;},{&quot;Text&quot;:&quot;大量输液后&quot;,&quot;Value&quot;:&quot;15&quot;},{&quot;Text&quot;:&quot;输血液制品后&quot;,&quot;Value&quot;:&quot;16&quot;},{&quot;Text&quot;:&quot;服用药物后&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;大量饮酒后&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;干呕后&quot;,&quot;Value&quot;:&quot;4&quot;},{&quot;Text&quot;:&quot;剧烈呕吐后&quot;,&quot;Value&quot;:&quot;5&quot;},{&quot;Text&quot;:&quot;进食后&quot;,&quot;Value&quot;:&quot;6&quot;},{&quot;Text&quot;:&quot;精神紧张&quot;,&quot;Value&quot;:&quot;7&quot;},{&quot;Text&quot;:&quot;受凉后&quot;,&quot;Value&quot;:&quot;8&quot;},{&quot;Text&quot;:&quot;受到刺激&quot;,&quot;Value&quot;:&quot;9&quot;}]" style="font-size: 12pt; text-align: justify;">无明显诱因</a><span style="font-size: 12pt; text-align: justify;">，</span></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;">    </label>
		<a tabindex="0" id="MainOutHospDiagCode" name="出院主要疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field335" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">    其他诊断：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field313" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field387" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field353" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">其他诊断：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<a tabindex="0" id="OtherOutHospDiagName1" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="OtherOutHospDiagCode1" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field374" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field259" name="qtzd" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<a tabindex="0" id="field314" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field388" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field354" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">           </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field306" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;"> </label>
		<a tabindex="0" id="field372" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field336" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field315" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field344" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field355" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">           </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field308" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;"> </label>
		<a tabindex="0" id="field373" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field337" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field316" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field346" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field356" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
		</tr>
		<tr style="height: 24px;">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">           </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field309" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field345" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field338" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field343" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field347" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field357" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">           </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field310" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field384" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field339" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field368" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt;">   </label>
		<a tabindex="0" id="field348" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field360" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">           </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field311" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;"> </label>
		<a tabindex="0" id="field385" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field340" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field369" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field350" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field361" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">           </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field312" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field386" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field341" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field371" name="出院其他诊断" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field352" name="出院其他疾病编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field362" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a></p></td>
		</tr>
		</tbody></table></p><p>
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">入院病情：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt;">1.有 2.临床未确定 3.情况不明 4.无              </label></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">损伤、中毒的外部原因</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field133" name="sszdwbyy" class=" input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="                                                " placeholder="-">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">                                                </label></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">疾病编码</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field53" name="diseaseCode" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;">
	<p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">病理诊断：</label>
		<a tabindex="0" id="field54" name="blzd" class=" input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="                                                           " placeholder="-">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">                                                           </label></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">疾病编码</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field55" name="diseaseCode" class=" input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="                       " placeholder="-">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">                       </label></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">                                                                                       </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">病理号</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field56" name="blh" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;">
	<p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">药物过敏</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field282" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.无2.有，过敏药物：</label>
		<a tabindex="0" id="field134" name="gmyw" class=" input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="                                   " placeholder="-">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">                                   </label></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">死亡患者尸检</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field286" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.是 2.否</label></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;">
	<p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">血型 </label>
		<a tabindex="0" id="field287" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;},{&quot;Text&quot;:&quot;5&quot;,&quot;Value&quot;:&quot;5&quot;},{&quot;Text&quot;:&quot;6&quot;,&quot;Value&quot;:&quot;6&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> 1.A  2.B  3.O  4.AB  5.不详  6.未查                   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">Rh </label>
		<a tabindex="0" id="field288" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  1.阴  2.阳  3.不详  4.未查</label></p></td>
		</tr>
		<tr style="height:1.8545197288135593cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">科主任</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field135" name="kzr" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">主任（副主任）医师</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field136" name="zrys" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">主治医师</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field60" name="zzys" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">住院医师</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field61" name="zyys" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">责任护士</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field62" name="zrhs" class=" input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="            " placeholder="-">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">            </label></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">进修医师</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field63" name="jxys" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">实习医师</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field64" name="sxys" class=" input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="             " placeholder="-">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">             </label></a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">编码员</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field65" name="bmy" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		<tr style="height:1.2704801355932203cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;">
	<p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">病案质量</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field289" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.甲 2.乙 3.丙   </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">质控医师</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field66" name="zkys" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">质控护士</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field67" name="zkhs" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">质控日期</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label><a tabindex="0" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" id="QCDate" name="质控日期" type="DateTime" format="yyyy-MM-dd " value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label></p></td>
		</tr>
		</tbody></table></p><p>
		<a tabindex="0" id="field351" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Justify; display: none;" contenteditable="true" type="Text" value="" placeholder="  -     ">  -     </a>
		<table style="">
		<colgroup>
		<col style="width:238px">
		<col style="width:238px">
		<col style="width:238px">
		</colgroup>
		<tbody><tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 12pt;">
		<table style="">
		<colgroup>
		<col style="width:62px">
		<col style="width:76px">
		<col style="width:38px">
		<col style="width:177px">
		<col style="width:63px">
		<col style="width:66px">
		<col style="width:61px">
		<col style="width:55px">
		<col style="width:50px">
		<col style="width:58px">
		</colgroup>
		<tbody><tr style="height:-0.6814971533898305cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style="">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;"> 手术及</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">操作</label>
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">编码</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">手术及</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">操作</label>
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">日期</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">手术</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">级别</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">手术及操作名称</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">手术及操作者</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">切口愈</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">合</label>
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">类别</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">  麻醉</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">  方式</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">  麻醉</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold; text-align: Center;">  医师</label></p></td>
		</tr>
		<tr style="height:0.5536722881355932cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=""></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=""></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=""></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;"></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">术者</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">Ⅰ助</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">Ⅱ助</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=""></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;"></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;"></p></td>
		</tr>
		<tr style="height:0.5cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="OPSCode1" name="手术及操作编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334033" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334034" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334036" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334037" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="FirstOPSAss1" name="第一助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
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		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334040" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334042" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334043" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
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		<tr style="height:0.4152542372881356cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field363" name="手术及操作编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334045" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334046" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334048" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334049" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field307" name="第一助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field375" name="第二助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field325" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;0&quot;,&quot;Value&quot;:&quot;0&quot;},{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;}]" value="" placeholder="0">0</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334054" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334055" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
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		<tr style="height:0.3898305084745763cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field365" name="手术及操作编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334057" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334058" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334060" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334061" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field380" name="第一助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field376" name="第二助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field326" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;0&quot;,&quot;Value&quot;:&quot;0&quot;},{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;}]" value="" placeholder="0">0</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
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			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334067" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
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		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field366" name="手术及操作编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334069" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334070" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334072" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334073" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field381" name="第一助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field377" name="第二助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field327" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;0&quot;,&quot;Value&quot;:&quot;0&quot;},{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;}]" value="" placeholder="0">0</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334078" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334079" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
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		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field367" name="手术及操作编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334081" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334082" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334084" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334085" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field382" name="第一助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field378" name="第二助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field328" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;0&quot;,&quot;Value&quot;:&quot;0&quot;},{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;}]" value="" placeholder="0">0</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334090" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334091" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370" name="手术及操作编码" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334093" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 7.5pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334094" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334096" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334097" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field383" name="第一助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field379" name="第二助手" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;"> </label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field329" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;0&quot;,&quot;Value&quot;:&quot;0&quot;},{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;}]" value="" placeholder="0">0</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334102" class="blank input" style=" font-family: 宋体; font-size: 9pt; text-align: Center;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="field370636721904828334103" name="ssjczbm" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		</tbody></table></p><p>
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">切口类别：</label>
		<label style=" font-family: 宋体; font-size: 9pt;">0.0类切口 1.I类切口 2.Ⅱ类切口 3.III类切口</label></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">离院方式 </label>
		<a tabindex="0" id="field292" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.医嘱离院  2.医嘱转院</label>
		<label style=" font-family: 宋体; font-size: 9pt;">，</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">拟接收医疗机构名称</label>
		<a tabindex="0" id="RecvHospName" name="拟接收医疗机构名称" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">3.医嘱转社区卫生服务机构/乡镇卫生院，拟接收医疗机构名称：</label>
		<a tabindex="0" id="field305" name="拟接收医疗机构名称" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt;">4.非医嘱离院 5.死亡 9.其他</label></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">是否有出院31天内再住院计划 </label>
		<a tabindex="0" id="field293" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">1.无  2.有，目的： </label>
		<a tabindex="0" id="field219" name="aim" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">颅脑损伤患者昏迷时间：入院前</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field220" name="day" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">天 </label>
		<a tabindex="0" id="field221" name="hour" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">小时</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field222" name="minutes" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">分钟      入院后 </label>
		<a tabindex="0" id="field223" name="day" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">天 </label>
		<a tabindex="0" id="field225" name="hour" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">小时 </label>
		<a tabindex="0" id="field76" name="minutes" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">分钟</label></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">住院费用（元）：总费用</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="TotalPay" name="总费用" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">（自付金额：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="ZiFuPay" name="自付金额" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">）</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">1.综合医疗服务类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(1)一般医疗服务费：</label>
		<a tabindex="0" id="MedServiceFee" name="一般医疗服务费" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">((2)一般治疗操作费：</label>
		<a tabindex="0" id="field229" name="ybzlczf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (3)护理费：</label>
		<a tabindex="0" id="field230" name="hlf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (4)其他费用：</label>
		<a tabindex="0" id="field231" name="qtfy" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">2.诊断类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(5)病理诊断费：</label>
		<a tabindex="0" id="field233" name="blzdf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (6)实验室诊断费：</label>
		<a tabindex="0" id="field234" name="syszdf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (7)影像学诊断费：</label>
		<a tabindex="0" id="field235" name="yxxzdf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (8)临床诊断项目费：</label>
		<a tabindex="0" id="field86" name="lczdxmf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">3.治疗类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(9)非手术治疗项目费：</label>
		<a tabindex="0" id="field236" name="fsszlxmf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">（临床物理治疗费：</label>
		<a tabindex="0" id="field237" name="lcwlzlf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">）</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">          (10)手术治疗费：</label>
		<a tabindex="0" id="field238" name="sszlf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">（麻醉费：</label>
		<a tabindex="0" id="field239" name="mzf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">手术费：</label>
		<a tabindex="0" id="field241" name="ssf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">）</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">4.康复类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(11)康复费：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
		<a tabindex="0" id="field242" name="kff" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  </label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">5.中医类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(12)中医治疗费：</label>
		<a tabindex="0" id="field243" name="zyzlf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">6.西药类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(13)西药费：</label>
		<a tabindex="0" id="WestMedicalFee" name="xyf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">（抗菌药物费用：</label>
		<a tabindex="0" id="field245" name="kjywfy" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">）</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">7.中药类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(14)中成药费：</label>
		<a tabindex="0" id="field96" name="zcyf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (15)中草药费：</label>
		<a tabindex="0" id="field246" name="zcyf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">8.血液和血液制品类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(16)血费：</label>
		<a tabindex="0" id="field247" name="xf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (17)白蛋白类制品费：</label>
		<a tabindex="0" id="field248" name="bdblzpf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (18)球蛋白类制品费：</label>
		<a tabindex="0" id="field249" name="qdblzpf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">                    (19)凝血因子类制品费：</label>
		<a tabindex="0" id="field250" name="nxyzlzpf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> (20)细胞因子类制品费：</label>
		<a tabindex="0" id="field251" name="xbyzlzpf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Justify;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">9.耗材类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">(21)检查用一次性医用材料费：</label>
		<a tabindex="0" id="field252" name="jcyycxyyclf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">（22）治疗用一次性医用材料费：</label>
		<a tabindex="0" id="field253" name="zlyycxyyclf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
	</p><p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">          (23)手术用一次性医用材料费：</label>
		<a tabindex="0" id="field254" name="ssyycxyyclf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label>
	</p><p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">10.其他类：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">（24）其他费：</label>
		<a tabindex="0" id="field106" name="qtf" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> </label></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-left:3.75pt;padding-right:3.75pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt; font-weight: bold;">转入方式：</label>
		<a tabindex="0" id="field294" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  1.转自医联体</label>
		<a tabindex="0" id="field295" name="receiveInst" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;">   2.社区转入</label>
		<a tabindex="0" id="field296" name="receiveInst" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 12pt;">
		<label style=" font-family: 宋体; font-size: 9pt;">               3.其他</label>
		<a tabindex="0" id="field297" name="receiveInst" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;"> </label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt;">日常生活能力评定量表（入院）得分：</label>
		<a tabindex="0" id="field298" name="receiveInst" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt;">       </label>
		<label style=" font-family: 宋体; font-size: 9pt;">日常生活能力评定量表（出院院）得分</label>
		<a tabindex="0" id="field299" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt;">临床路径：</label>
		<a tabindex="0" id="field300" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;0&quot;,&quot;Value&quot;:&quot;0&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 0.未入路   1.完成    2.变异     3.退出</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">抗生素使用情况：使用</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;"> </label>
		<a tabindex="0" id="field301" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.使用    2.无       目的：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;"> </label>
		<a tabindex="0" id="field302" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.预防 2.治疗</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">                方案</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;"> </label>
		<a tabindex="0" id="field303" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.单独用药           2.联合用药        使用天数</label>
		<a tabindex="0" id="field317" name="day" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">天</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">传染病报告</label>
		<a tabindex="0" id="field318" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.有    2.无</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt;">特别护理天数</label>
		<a tabindex="0" id="field319" name="day" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">天  护理级别</label>
		<a tabindex="0" id="field320" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.一级护理  2.二级护理   3.三级护理</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">住院期间是否出现危重</label>
		<a tabindex="0" id="field321" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.是   2.否                        是否有非计划二次手术</label>
		<a tabindex="0" id="field322" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.是   2.否</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">住院过程中有无进入重症监护 </label>
		<a tabindex="0" id="field323" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.是   2.否</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">重症监护室名称：</label>
		<a tabindex="0" id="field333" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">  进入时间：</label>
		<a tabindex="0" id="field358" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">   转出时间：</label>
		<a tabindex="0" id="field359" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">诊断符合情况：入院与出院</label>
		<a tabindex="0" id="field324" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.符合   2.不符合       术前与术后</label>
		<a tabindex="0" id="field330" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.符合   2.不符合   </label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">              临床与病理</label>
		<a tabindex="0" id="field331" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;0&quot;,&quot;Value&quot;:&quot;0&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 0.未做   1.符合    2.不符合     3.不肯定</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt;">主要诊断出院情况：</label>
		<a tabindex="0" id="field332" class="blank input" style=" font-family: 宋体; font-size: 7.5pt; color: #201F35;" type="DropdownList" data="[{&quot;Text&quot;:&quot;1&quot;,&quot;Value&quot;:&quot;1&quot;},{&quot;Text&quot;:&quot;2&quot;,&quot;Value&quot;:&quot;2&quot;},{&quot;Text&quot;:&quot;3&quot;,&quot;Value&quot;:&quot;3&quot;},{&quot;Text&quot;:&quot;4&quot;,&quot;Value&quot;:&quot;4&quot;},{&quot;Text&quot;:&quot;5&quot;,&quot;Value&quot;:&quot;5&quot;}]" value="" placeholder="1">1</a>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;"> 1.治愈  2.好转  3.未愈   4.死亡    5.其他</label></p></td>
		</tr>
		</tbody></table></p><p>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35; font-weight: bold;">说明：</label>
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">医疗付费方式  1.城镇职工基本医疗保险 2.城镇居民基本医疗保险 3.新型农村合作医疗 4.贫困救助  5.商业 </label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt; color: #201F35;">                    6.公费   7.全自费   8.其他社会保险  9.其他</label>
	</p><p style=" font-family: 宋体; font-size: 9pt;">
	</p><p style=" font-family: 宋体; font-size: 9pt;">
		<a tabindex="0" id="field334" class=" input" style=" font-family: 宋体; font-size: 9pt;" contenteditable="true" type="Text" value="婴儿序号 性别 分娩结果 婴儿体重
(g) 婴儿转归 呼吸 抢救次数 抢救成功次数 
男性 女性 活产 死产 死胎 死亡 转科 出院 自然 Ⅰ度窒息 Ⅱ度窒息 
1                             
2                             
  3                             
4                             " placeholder="">
		<table style="">
		<colgroup>
		<col style="width:38px">
		<col style="width:32px">
		<col style="width:38px">
		<col style="width:48px">
		<col style="width:49px">
		<col style="width:53px">
		<col style="width:68px">
		<col style="width:52px">
		<col style="width:52px">
		<col style="width:56px">
		<col style="width:45px">
		<col style="width:43px">
		<col style="width:43px">
		<col style="width:41px">
		<col style="width:50px">
		</colgroup>
		<tbody><tr style="height:0.5cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">婴儿序号</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;" colspan="2">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">性别</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">分娩结果</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">婴儿体重</label>
	</p><p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">(g)</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">婴儿转归</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;" colspan="3">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">呼吸</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">抢救次数</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">抢救成功次数</label></p></td>
		</tr>
		<tr style="height:0.5cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;"></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">男性</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">女性</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">活产</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">死产</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">死胎</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;"></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">死亡</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">转科</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">出院</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">自然</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">Ⅰ度窒息</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">Ⅱ度窒息</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;"></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;"></p></td>
		</tr>
		<tr style="height:0.5cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">1</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="IsMale1" name="男性" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="IsFemale1" name="女性" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="LiveBirth1" name="活产" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="DeathBirth1" name="死产" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="StillBirth1" name="死胎" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyWeight1" name="婴儿体重" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyDead1" name="死亡" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyTransfer1" name="转科" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyOutHosp1" name="出院" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="NatrualBreath1" name="自然" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="Type1Apnea1" name="一度窒息" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="Type2Apnea1" name="二度窒息" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabySavedTime1" name="抢救次数" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabySavedSucTime1" name="抢救成功次数" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		<tr style="height:0.4152542372881356cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">2</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="IsMale2" name="男性" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="IsFemale2" name="女性" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="LiveBirth2" name="活产" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="DeathBirth2" name="死产" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="StillBirth2" name="死胎" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyWeight2" name="婴儿体重" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyDead2" name="死亡" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyTransfer2" name="转科" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyOutHosp2" name="出院" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="NatrualBreath2" name="自然" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="Type1Apnea2" name="一度窒息" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="Type2Apnea2" name="二度窒息" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabySavedTime2" name="抢救次数" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabySavedSucTime2" name="抢救成功次数" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		<tr style="height:0.3898305084745763cm">
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt;">
		<label style=" font-family: 宋体; font-size: 9pt;">  3</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="IsMale3" name="男性" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="IsFemale3" name="女性" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="LiveBirth3" name="活产" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="DeathBirth3" name="死产" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="StillBirth3" name="死胎" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyWeight3" name="婴儿体重" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyDead3" name="死亡" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyTransfer3" name="转科" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyOutHosp3" name="出院" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="NatrualBreath3" name="自然" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="Type1Apnea3" name="一度窒息" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="Type2Apnea3" name="二度窒息" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabySavedTime3" name="抢救次数" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabySavedSucTime3" name="抢救成功次数" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
		</tr>
		<tr>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<label style=" font-family: 宋体; font-size: 9pt; text-align: Center;">4</label></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="IsMale4" name="男性" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="IsFemale4" name="女性" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="LiveBirth4" name="活产" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="DeathBirth4" name="死产" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="StillBirth4" name="死胎" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyWeight4" name="婴儿体重" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyDead4" name="死亡" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyTransfer4" name="转科" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabyOutHosp4" name="出院" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="NatrualBreath4" name="自然" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="Type1Apnea4" name="一度窒息" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
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			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
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			<td style=" font-family: 宋体; font-size: 12pt;padding-right:5.25pt;">
	<p style=" font-family: 宋体; font-size: 9pt; text-align: Center;">
		<a tabindex="0" id="BabySavedSucTime4" name="抢救成功次数" class="blank input" style=" font-family: 宋体; font-size: 9pt; color: #201F35;" contenteditable="true" type="Text" value="" placeholder="-">-</a></p></td>
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		</tbody></table></a></p><p>
</p></div>

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